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KMID : 1155520100050040295
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Anesthesia and Pain Medicine
2010 Volume.5 No. 4 p.295 ~ p.300
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Effect-site concentration of remifentanil to blunt the hemodynamic changes during rapid sequence intubation
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Lee Young-Min
Lee Jeoung-Hyuk
In Jun-Yong
Lee Youn-Suk
Yoon Myung-Ha
Kim Woong-Mo
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Abstract
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Background:This study was undertaken to evaluate the effect-site concentration of remifentanil to blunt the hemodynamic changes during rapid sequence intubation.
Methods:Eighty patients were enrolled and divided into four groups being assigned with different effect-site concentrations (Ce) of remifentanil of 0, 2, 3, or 4 ng/ml. Patients arrived at the operating room without premedication and their baseline vital signs were recorded. With preoxygenation of 100% O2, remifentanil was infused by target controlled infusion according to patient group. After achievement of a stable level of Ce, propofol 2 mg/kg and rocuronium 1.2 mg/kg were injected and the trachea was intubated one minute later. Hemodynamic changes were recorded at 1, 2, and 3 min after remifentanil infusion, immediately before and after endotracheal intubation, and 1 and 2 min after endotracheal intubation.
Results:The 50% effective Ce of remifentanil was 1.4 ng/ml (95% confidence interval, CI: 0.9?1.8) to blunt the increase of mean blood pressure and was 2.4 ng/ml (95% CI: 1.6?3.1) to blunt the increase of heart rate. The 50% Ce for the decrease of mean blood pressure was 2.8 ng/ml (95% CI: 2.2?3.4).
Conclusions:During the rapid sequence intubation, the 50% effective effect site concentration of remifentanil to prevent hemodynamic changes is between 2.4 and 2.8 ng/ml.
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KEYWORD
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Heart rate, Mean blood pressure, Rapid sequence intubation, Remifentanil
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